Since being paralyzed almost three decades ago, Dean Juntunen has competed in more than 90 wheelchair marathons, continued snowmobiling and four-wheeling, and taken up kayaking.
Now, Juntunen is taking another significant step. And then another step. And then another.
"Just standing talking to you is interesting," Juntunen said. "I had not gone from a sitting position to a standing position in 27 years. I got injured in '91, so just standing is fun. I like just standing up and moving around."
About 160 veterans are participating in the program at 15 VA Centers across the country. After completing a series of rigorous training sessions, veterans in this study will take the exoskeleton home for use in everyday life.
Juntunen executes a challenging 180-pivot with the aid of VA trainers Cheryl Lasselle (left) and Zach Hodgson.
Participants must meet certain criteria, including bone density. Users should be between about 5-foot-3 and 6-foot-3 and cannot weigh more than 220 pounds.
"Most paralyzed people, if not all, lose bone density," Juntunen said. "So, you have to pass a bone density scan to qualify for this program. I happen to have unusually good bone density and I've been paralyzed for 27 years."
Juntunen was on active duty when he was injured in between assignments from Malmstrom AFB in Great Falls, Montana, to Wright-Patterson AFB in Dayton, Ohio, when his life changed.
Fell 30 feet, broke spinal cord in two places
An avid hiker and outdoorsman, Juntunen's life changed when a tree branch gave way and he fell 30 feet to the ground.
"I landed on my back in a fetal position," said Juntunen, who lives near Mass City in Michigan's Upper Peninsula. "Spine folded in half, broke five vertebrae, wrecked my spinal cord in two spots."
"Well, I have a hard time saying no and they strongly asked me to do it. So, I decided, that's probably going to be fun playing with that robot. I guess I'll make a bunch of trips to Milwaukee."
Juntunen, who has an engineering degree, said the hardest part of mastering the robotic device was developing balance.
"One of the hardest things about getting paralyzed is relearning your sense of balance because you can't feel anything through your butt," he said. "I'm paralyzed from the base of the rib cage down, so it's like I'm sitting on a stump all the time."
Turns and pivots presented challenges, as did going up an incline, he said.
"I liken this to walking on stilts for an able-bodied person because you have to feel the ground through wooden or metal legs. That's basically what I'm doing in this thing."
"I don't really describe this as walking, more like riding the robot," he said. "The interesting thing is, my brain feels like it's walking. I'm a complete injury, so I can't feel anything. My brain has no idea what my legs are doing, but nonetheless, it feels like I'm walking in my head."
Not all participants are able to sufficiently master the nuances of the 51-pound device to meet the requirements of the study.
Basic training needed to master balance skills
"Some people don't get past what we call the basic training," said Joe Berman, Milwaukee VA project manager. "To be eligible to go into the advanced training, you have to be able to master some balance skills and do five continuous steps with assistance within five training sessions. That's been shown by previous research to be a good predictor of who is going to succeed in passing the advanced skills that we require to take the device home."
The training sessions at Milwaukee last about two to two-and-a-half hours, usually twice a day. With the aid of certified trainers, Juntunen walked up to a quarter mile, starting with the lightly trafficked tunnel between the main hospital and the Spinal Cord Injury Center.
When Juntunen takes the device home, companions trained to assist will replace the VA trainers.
He eventually progressed to one of the main public entries to the hospital, which had inclines, carpeted areas, and pedestrian traffic.
"The inclines are harder," Juntunen said. "Here, you've got short incline, then flat, then incline, so the transitions are harder. You're in balance going down and when it flattens out, you have to change where your balance is, so the transition is a little trickier. Coming up is the worst, up the ramps is the hardest. You kind of have to reach behind you with the crutches. It's more exertion and more difficult on the balance because the robot is always perpendicular to the surface."
Mastering use of the device in the public space was part of the requirement before Juntunen can take it home.
"In order to take the device home, they need to be able to navigate up and down Americans with Disabilities Act (ADA)-compliant ramps and go through doorways," said Zach Hodgson, a physical therapist at the Milwaukee VA and part of the certified training team. "Right now, we have three trainers, but at home, he'll need a companion to walk with him at all times. It's looking at all those skills we need to get to and then making plans based on how he's progressing."
"He's going to use this device in his home and community so we really get a good idea about how useful these devices are," Hodgson said.
At home, companions replace the VA trainers to help with the device. In Juntunen's case, he's getting help from his kayaking buddies.
"They've seen me transferring and stuff," he said. "They know I can sit and balance, sit on the edge of my kayak before I transfer up to the seat. So, that's all normal for them."
After completing training in Milwaukee, Juntunen is scheduled to have another session at a shopping mall in Houghton, Michigan, tentatively followed by another session in the atrium of the Green Bay Packers Hall of Fame.
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